“I had made the decision, and no one was going to stop me” -Facilitators of prep adherence during pregnancy and postpartum in cape town, South Africa
Date
2021Author
Davey, Dvora L. Joseph
Knight, Lucia
Markt‑Maloney, Jackie
Metadata
Show full item recordAbstract
PrEP is safe and efective but requires adherence during potential HIV exposure, yet the facilitators of long-term maternal
adherence are not well understood. We conducted semi-structured interviews with 25 postpartum women who reported
high adherence (PrEP use≥25 days in last 30-days and never missed a PrEP prescription in pregnancy/postpartum period)
within a PrEP service for pregnant and postpartum women. A thematic approach guided an iterative process of coding and
analysis. Themes identifed as drivers of optimal PrEP use were HIV risk perception, mainly because of partner’s behaviors
and unknown serostatus, and a strong desire to have a baby free of HIV. Reported disclosure of PrEP use facilitated PrEP
adherence. Women discussed having partner and family support, which included reminders to take PrEP daily. Primary
barriers were anticipated or experienced stigma, overcome through education of partners and family about PrEP. Pregnant
women experienced transient side-efects, but found ways to continue, including taking PrEP at night. PrEP programs for
pregnant and postpartum women should integrate strategies to assist women with realistic appraisals of risk and teach skills
for disclosure and securing support from signifcant others.